New Hampshire

A few weeks ago I posted my analysis of the preliminary 2026 individual & small group market filings for New Hampshire, concluding that the state is looking at average rate hikes of around 22.4% for the indy market and perhaps 13% for small group plans.

For the individual market, this is actually slightly lower than the national average (23.4%), and New Hampshire will still end up with the 2nd-lowest avg. premiums in the country (Idaho should be slightly lower next year), but 22.4% is still pretty steep, and the state insurance dept. isn't happy about it:

 

New Hampshire Insurance Department Urges Health Carriers to Submit Revised 2026 Premium Rates Reflecting Current Economic Conditions

Originally posted 12/05/25

New Hampshire has around ~70,000 residents enrolled in ACA exchange plans, 71% of whom are currently subsidized. I estimate they also have another ~14,000 unsubsidized off-exchange enrollees.

Combined, that's 85,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 80,000 statewide.

Originally posted 8/08/25

Overall preliminary rate changes via the SERFF database, New Hampshire Insurance Dept. and/or the federal Rate Review database.

Anthem Health Plans of NH (BCBS)

(Unfortunately, Anthem has redacted their current enrollment total; see below)

This is a rate filing for the Individual market ACA-compliant plans offered by Anthem Health Plans of New Hampshire, Inc., also referred to as Anthem. The policy forms associated with these plans are listed below. The proposed rates in this filing are for a new HMO product that will be effective for the 2026 plan year beginning January 1, 2026, and apply exclusively to off-exchange plans.

Over the past couple of months I've compiled a master spreadsheet breaking out enrollment in ACA plans (Qualified Health Plans & Basic Health Plans), Medicaid/CHIP coverage (both traditional & via ACA expansion) and Medicare (both Fee-for-Services & Advantage) at the Congressional District levels.

With the pending dire threat to several of these programs (primarily Medicaid & the ACA) from the House Republican Budget Proposal which recently passed, I'm going a step further and am generating pie charts which visualize just how much of every Congressional District's total population is at risk of losing healthcare coverage.

USE THE DROP-DOWN MENU ABOVE TO FIND YOUR STATE & DISTRICT.

The good news about New Hampshire's health insurance market is that they're the only state without its own ACA exchange which produces publicly-accessible monthly reports on individual on-exchange market enrollment. The bad news is that they don't seem to publish the actual rate filings in an easy-to-read format, which means I'm left with the federal rate review website, which sometimes posts average rate requests which don't match up with the actual filings...but it's gonna have to do here. 

With these two data sources in hand, New Hampshire's individual market carriers are asking for a weighted average increase of 4.8%. It's important to note that Anthem Health Plans and Matthew Thornton Health Plan are listed as separate carriers on the federal Rate Review website (with separate average rate requests), but on the state's monthly report, they're merged into a single listing.

With no way of knowing what the actual enrollment breakout is between these two, I'm assuming a 50/50 split.

Earlier this week the Centers for Medicare & Medicaid Services (CMS) announced that they had approved Missouri's plan to take advantage of the Biden administration's Maternal Health Blueprint (made possible by the American Rescue Plan & Consolidated Appropriations Act) to extend postpartum Medicaid/CHIP coverage to a full 12 month period:

As a result of today’s announcement, up to an additional 18,000 people in Missouri will be eligible for Medicaid for a full year after pregnancy. Medicaid covers 41% of all births in the nation and more than half of all children in the country. With the approval of Missouri’s plan, an estimated 641,000 Americans across 40 states, the District of Columbia, and the U.S. Virgin Islands now have access to extended postpartum coverage. If all states adopted this option, as many as 720,000 people across the United States would be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy.

via the New Hampshire Insurance Dept:

New Hampshire Insurance Department Announces the Launch of 2024 Open Enrollment Period for Affordable Care Act Individual Marketplace and Releases 2024 Premium Rates

CONCORD, NH (October 31, 2023) – Today, the New Hampshire Insurance Department (NHID) kicked off the Open Enrollment Period for Granite Staters who are seeking individual health coverage on the Affordable Care Act (ACA) Individual Marketplace. The Open Enrollment Period runs from Tuesday, November 1, 2023, through Sunday, January 15, 2024.

“This is a significant opportunity for Granite Staters who do not have health insurance through their employer, Medicare, or Medicaid to enroll in the Individual Marketplace,” said New Hampshire Insurance Commissioner DJ Bettencourt. “For the fourth consecutive year, the 1332 Waiver has resulted in premiums for the individual market being the lowest in New England, ensuring more individuals have access to the healthcare they need.”

The good news about New Hampshire's health insurance market is that they're the only state without its own ACA exchange which produces publicly-accessible monthly reports on individual on-exchange market enrollment. The bad news is that they don't seem to publish the actual rate filings in an easy-to-read format, which means I'm left with the federal rate review website, which sometimes posts average rate requests which don't match up with the actual filings...but it's gonna have to do here. 

With these two data sources in hand, New Hampshire's individual market carriers are asking for a weighted average increase of 3.1%. It's important to note that Anthem Health Plans and Matthew Thornton Health Plan are listed as separate carriers on the federal Rate Review website (with separate average rate requests), but on the state's monthly report, they're merged into a single listing.

New Hampshire

The good news about New Hampshire's health insurance market is that they're the only state without its own ACA exchange which produces publicly-accessible monthly reports on individual on-exchange market enrollment. The bad news is that they don't seem to publish the actual rate filings in an easy-to-read format, which means I'm left with the federal rate review website. The problem with that is the rate filings are mostly heavily redacted, making it impossible to get the total enrollment data.

via the New Hampshire Insurance Dept:

New Hampshire Insurance Department Kicks Off 2023 Open Enrollment Period And Releases Premium Rates

Despite difficult national economic headwinds, New Hampshire’s rates remain the lowest in New England.

Rate Changes

As I noted last night, thanks to the federal Rate Review website finally being updated to include the final, approved 2022 rates for both the individual and small group markets in all 50 states (+DC), I've been able to fill in the missing data for my annual ACA Rate Change Project.

As I note there, the overall weighted average looks like it'll be roughly +3.5% nationally.

Normally I write up a separate entry for both the preliminary and approved rate changes in each individual state, but it seems like overkill to create 14 separate entries at once. Besides, in many of these states there's been few if any changes between the preliminary and approved rate changes.

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